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Individual

MOSES OGUNYOYE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12158 CENTRAL AVE, MITCHELLVILLE, MD 20721-1932
(301) 430-2700
Mailing address
1508 ROBERT LEWIS AVE, UPPER MARLBORO, MD 20774-5652
(301) 928-8837

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41201651600
MD
Enumeration date
04/16/2021
Last updated
04/16/2021
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